Remember that the pathology which every remedy represents and cures in the human organism can be conceived as an 'idea' rather than as a heap of disconnected symptoms. The important remedies of our materia medica have been proven extensively and their symptomatology is sufficiently comprehensive for the contemplative student to extract from it the prevailing 'idea'.

THE ESSENTIAL FEATURES

In Bryonia we have a patient who is emotionally, bodily and mentally dried up. He wants to be left alone, undisturbed, while at the same time constantly needing great quantities of water to balance his dryness. If this is looked at symbolically, we see that the water element, symbolising the emotions, is lacking or restricted. It will be apparent to you when you look upon a typical constitu¬tional Bryonia type that there is an element of dehydration at all levels. The sensation of dryness of the mucous membranes is most frequently reported, but the dryness of Bryonia extends to the emotional and mental levels as well. The mind is dry; in other words, the mind lacks nimbleness and agility, it is unimaginative.

Stiffness of the Mind

Constitutional Bryonia patients suffer from a stiffness of the mind; they tend to be very business-like and matter-of-fact. Their pers¬pective is quite limited or earthy. Consequently, they often focus their energies upon the attainment of earthly things and material security, especially money. Underlying their rather gruff, business¬like manner, however, a sense of financial insecurity dwells, and the primary expression of this insecurity in Bryonia patients is a fear of poverty. They are afraid of being poor one day, irrespective of the degree of their bank balance or business success.

Bryonia is a remedy which is indicated quite frequently today. The need for Bryonia is quite possibly a result of the pressures arising from the prevailing socio-economic system. The pressures to perform effectively in the business world and to achieve financial success in the face of fierce competition can have a profound influence upon one's psychological functioning. As a consequence, many suscep¬tible individuals will develop the mental, emotional, and physical pathological indications for Bryonia.

The Bryonia individual, most often a male, will be one who primarily wishes to be alone. This desire to be alone is attribut¬able to a great amount of internal irritability and anger. Underlying the irritability is a considerable sense of insecurity expressed with an irrational fear of poverty and also fear about the future and, most specifically, about the future as it relates to his financial situation.

These people are very business-like. Business concerns even occupy their subconscious mind; as a consequence, they often will talk about business while in a delirium. As one might expect, these people will be very careful with their money and are reluctant to part with it, though they are not stingy to the extent of Arsenicum or Mercury.

It is unlikely that a Bryonia case would buy expensive goods for himself which he feels to be unnecessary. He may however spend money for a good cause. The Bryonia attitude is a materialistic one. Bryonia patients are earth-bound; i.e., earthy in their perspectives and attitudes. They will pursue with determination whatever they decide would be beneficial for them. Bryonia patients with any inter¬est in spiritual matters are definitely the exception. Emotional Dryness and Desire for Solitude The emotional dryness manifests in the patients' irritability and peevishness, major characteristics of Bryonia. They are very serious people, lacking in imagination. They are neither playful nor joyful; seldom will they attempt a joke.

Typically these people lack refinement and sensitivity, but they do retain a specific sensitivity to annoyance. They do not welcome interference in their lives; they simply want to find their own niche, their place in life, and to be left alone. They are averse to being bothered by others because of the internal irritability which they are reluctant to show. The problem with any kind of interference is that there must be some reaction on their part; this is tremendously difficult and aggravates them. Their attitude is, "Leave me alone."

This is the nature of Bryonia, and we must perceive its inner structure along the same lines. The agility goes and a rigidity settles in. This individual is drying up, and in order to keep in balance he must have supplies of water, of emotions and of money, all of which must come from the outside. He is afraid that in his old age nobody will love him, nobody will care about him and he has to have money to pay people. Emotionally he cannot give love but he needs to feel loved in order to feel secure, in spite of the fact that when he is loved he does not appreciate it. He can be busy and excited, buying and selling on the stock market, for which he can have a great passion, but he is unable to fall passionately in love with a woman.

He cannot feel or express passion, although he can perform sexually. For a Bryonia individual, it is enough that his wife should love him and be available, but he is incapable of romance or appreciation of her tenderness. He is usually angry and irritable and inconsiderate towards others, and after sexual intercourse he retreats into himself and is better if no-one bothers him anymore.

In a description of this type it is not possible to describe all the variations of the remedy and all the different moods. The student of homeopathy is required to understand the main ideas that run through each remedy.

Dryness of the Physical Body and Thirst

This same attitude will be apparent when the patient has to move a painful joint. Moving the joint creates a dry and cracking sensation, and he hates to have to do it. This dryness is apparent at different levels of the physical body. The mucous membranes, serous mem¬branes or skin can dry up to a tremendous extent. Further examples of such dryness include: dryness of the conjunctiva of the eyes, so that the eyes cannot be moved without distress; dryness of the synovial membranes, so the joints cannot be moved without pain; dryness of the lining of the intestines so the stool will not move and a most distressing constipation sets in.

Bryonia is, of course, an extremely thirsty remedy. The thirst is for large quantities of cool or tepid water. In Bryonia there is a preference for warm drinks that actually make the patient feel better, often tepid tap water is quite sufficient. These characteristics help to distinguish Bryonia from such remedies as Phosphorus, Natrum muriaticum, and Sulphur which all desire great quantities of cold water frequently. Lycopodium, on the other hand desires and is ameliorated by warm drinks but the quantity of water they require is much less; Lac caninum, Arsenicum and Chelidonium also crave warm drinks.

As mentioned, Bryonia manifests great dryness of the mucous membranes in many conditions. One must be careful when analy¬sing a case however, because some Bryonia patients can experience great dryness of the mouth without thirst. There are other remedies which have dryness and a simultaneous aversion to water. One of these remedies, Nux moschata, possesses such great dryness that the tongue feels stuck to the palate, yet there is an aversion to water. If these patients even attempt to drink some water to help wash down some food, they will have to spit out the water; they cannot drink it; there is a complete absence of thirst. Natrum muriaticum often exhibits this symptom too.

So far we have given a description of the symptoms of the remedy. However, you should bear in mind the importance of the patho¬logical picture that presents itself when you combine all the symptoms, for this is where the peculiarity and uniqueness of this personality lie. On prescribing this remedy you should not lose sight of the dryness, of the aggravation from moving these dry parts, nor of the "do not bother me" attitude, and the persistent but slow development of the pathology. And beyond that, you should make an effort to understand the subtleties of the pathology of the personality.

As you perceive the idea behind a remedy, you find yourself prescribing it with more certainty and greater confidence than ever. If, however, you prescribe the remedy on symptoms alone, the margin for error remains very great. In order for one to be able to see these images and ideas correctly, it is necessary to have seen a lot of cases, and most of all to have prescribed the remedy correctly in several constitutional types.

When I started talking about these ideas more than 25 years ago my students got excited and became very receptive. As a side-effect of this excitement, several 'eager homeopaths' came on the scene, trying to copy these ideas, as a result creating confusion in the minds of those who were listening. Do not be tempted to fabricate ideas about the remedies before you have seen enough cases and gained some real insight into the remedies, and before being able to confirm your observations.

The Acute State

Bryonia is a remedy that will show persistence and determination, and will not vacillate. The complaints start slowly and develop steadily in a crescendo over a much longer period of time than most other remedies. Acute conditions take several days to reach their full-blown manifestation, whereas in other remedies - e.g. Aconite or Belladonna - we see a much more immediate and explosive reaction of the organism. Bryonia presents a slow but steady development of complaints, which persists until a very serious level is reached.

We can better understand the chronic state of Bryonia by examining Bryonia's acute state. Typically during severe Bryonia acute states, usually involving fever and bronchitis, patients realize that they need to muster all of their recuperative powers. Their suffering and irritability are tremendous. They want to be left alone in order to collect all their energy to ensure that they will be able to weather the illness. Even in their normal chronic condition Bryonia individuals don't easily seek help for mental or emotional problems; they would rather attempt to work their problems out by themselves. In this acute state they are dry and dehydrated. The mouth is very dry and there is a constant need to drink. Consequently, during a fever, the patients tend to become irritated when someone enters the room to talk to them, console them, or to offer help. They feel that quiet is the best thing for them. It is very distressing for them to have to react to anything, or even to have to move.

During a fever, the simple question, "Do you want a cup of tea?" is liable to make the Bryonia patient feel worse. He feels that the simple act of answering such a question will cause an aggravation by expending the recuperative powers. The usual observation made in a Bryonia case is that the person attending the patient will say that the patient is very ill and does not want any interference. On being offered a cup of tea, even though the patient is thirsty, he is aggravated by the fact that someone has disturbed him. But when the tea arrives, he will drink it with great relish. He is very thirsty and is often ameliorated by warm drinks.

However, the whole process of being asked and of having to respond remains very aggravating. In such a case it is best to leave the tea and go out of the room immediately. If you are sensitive enough you will perceive the aggravation, even without words. Kent writes: ‘Do not cross a Bryonia patient for it makes him worse.’ The patient himself feels that it is unfair to treat others, who are interested in him, in this way, but he cannot help it.

Aggravation From Movement

Exhaustion and sluggishness play a role in this unwillingness to interact with others when ill, but far more responsible is an irritability and a basic aversion to motion. Any motion - that of physically moving, even breathing or moving the eyes, or the effort of feeling or talking, even of thinking - aggravates Bryonia patients; they do not want to move. They are aggravated from movement; and here we have the greatest characteristic and key-note of Bryonia. Such is the aggravation from motion that you may not be able to make a physical examination, as the patient faints as soon as he tries to raise himself in bed.

I recall a case of Bryonia that I saw in South Africa. When I entered the patient's room, he was lying facing the wall. He coughed and lay perfectly still with his back towards me. During the entire visit I conversed through an interpreter, and the patient never once turned around to look at me; it was too painful for him to move. He offered very little information. The person who was interpreting and who had been caring for him said that he had had no appetite for two to three days, that he had been in a great deal of pain while coughing and would lie in one position only, never moving. He did not want anything; he only drank water from time to time. He was given Bryonia, and the next day he was much better and recovered without needing any other remedy.

The aggravation from movement of Bryonia makes it a good remedy for arthritic conditions. Severe arthritic inflammations that are aggravated by the slightest movement will often be benefited by Bryonia. An important observation, however, is that sometimes, when the joint pain is extremely intense, the pain can be so severe that, despite being aggravated by motion, the patient feels compelled to get up and walk about. The suffering is so great that he has to move. This paradoxical restlessness can at times create confusion with Arsenicum and Rhus toxicodendron.

A further important key-note of Bryonia is an amelioration from pressure. Many forms of pain and discomfort are ameliorated by holding and pressing upon the affected part. Lying on the painful side (e.g., in headaches, chest pain, etc.) frequently provides respite from the pain. An important observation in cases of acute appen¬dicitis corresponding to Bryonia is that there will seldom be tenderness to direct pressure. When the examiner's hand is sud¬denly removed from the abdomen, however, severe pain occurs. This presentation is classic for Bryonia: with pressure there is an amelioration of the pain, but the sudden release of pressure (sudden motion) provokes pain. Bryonia is one of the specific remedies for acute appendicitis; it will cure a very large percentage of cases which present with marked rebound tenderness and a lack of significant tenderness to direct pressure.

Bryonia is full of anxiety and despondency. He is not easily pleased with others, and often does not know himself what he really wants. There is an internal restlessness that forces him to move about, in spite of being aggravated by motion. There is anxiety and fear, including fear of death and fear that he will not recover from his illness. But his mind which is logical and practical does not allow the fears to overwhelm him. He may allow his temper, his anger, or his irritability to reach violent expressions, but he will not allow the fears to cloud his mind completely.

Kent writes: 'The mental state of Bryonia is usually relieved from cool air, he wants the windows open. Anxiety, confusion of mind, fear, etc., are ameliorated from being cool. Sometimes the delirium, and the congestive fullness of the head affecting the mind, will increase if the room becomes very warm, or from the heat of the stove, from becoming heated, or from warm covers. In children this will be noticed, whereas if the window be thrown up to relieve the stuffiness of the room the child will sleep quietly. Such remedies as Bryonia, Apis, Pulsatilla, and many others, come in here. If you go into a room and find the child raging with delirium, turning and tossing, and the mother is trying to keep the room warm because she is chilly, and say, "Why, how stuffy it is in here!", and you open the window and then notice that the child goes off to sleep, do not overlook that; because that relief was caused by something. There should be nothing that can possibly occur to a patient, but that you should solve the meaning of before you leave the room. Settle in your mind as to what it was that caused it.

"Fear of death ". Full of fear, anxiety, despair of recovery, great despondency. Both mental and bodily quietness is required, that is he wants to keep still. Often he wants the room dark. It has complaints from getting excited. Bryonia patients are nearly always worse from visitors. "Morose". Do not cross a Bryonia patient for it makes him worse. "Bad effects from mortific¬ation." "Ailments arising from chagrin"; these are headaches usually. Violent, congesting headaches that come on a few hours after altercation or controversy, or little misunder¬standings with somebody that he cannot talk back to, will be covered by Staph., but Bryonia also has that.

Staph, is suited to irritable, violent, nervous, excitable people, who get into violent altercation or dispute. If a headache comes on, such a patient may need Bryonia. If in a chronic state a patient says, "Doctor, if I ever have a dispute with a man over anything I come down with nervous excitement, sleeplessness, headaches;" you do not have to work long upon that case, because more than likely Staph, will be suitable.'

The Bryonia Child

Bryonia children, during acute illnesses, will often ask for things that they cannot have. In the midst of their fever and moaning they will call out their demands, which typically will be for several impossible things. Should their parents hand them one of the items, they will immediately throw it away like the Chamomilla child does. The especially characteristic trait, though, is that they ask for things that are difficult for the parents to find. There is a feeling of dissatis¬faction, of discontent inside them; they don't actually know what they want. "He wants something and he knows not what" is a very important symptom for Bryonia. It is a symptom that calls for Bryonia only when the rest of the symptoms agree. You go to a child who is being carried in the arms of the nurse and wants one toy after another; you get the toy he wants and he does not want it and will throw it back at you. When that case is looked into thoroughly it may be covered by Kreosotum; another is never satisfied with anything and rejects everything he asks for; you look into that case and it may be covered by Chamomilla.

A characteristic that one may at times encounter is a tendency for nose-bleeds in children during the night while they are in bed, between 3-4 a.m. Children seem weary, easily fall down from dizzi¬ness. In brain infections children perform a strange chewing motion as if they were chewing the cud. This usually occurs during sleep. The mouth may distort during sleep when there is brain involvement.

Delirium

Bryonia's well-known time of aggravation is the morning on waking and at 9 p.m.; there is a general aggravation at this time.

This is how Kent describes it:

'In rheumatic complaints, in pneumonia, and in typhoid conditions, when he is aroused from this stage of stupefaction he is confused, sees images, thinks he is away from home and wants to be taken home. Sometimes he will lie and say nothing but he "wants to go home." The delirium is of a low type: it is not the flashing wild excitement of Bell, or Stram.; it is the very opposite; he talks and wanders and does not say much unless he is disturbed. You disturb him and he says, "Go away and let me go home" and if you let him alone he will relapse into a perfectly quiet state and seldom speak. Irrational talk or prattle of his business aggravated after 3 p.m. Usually you will find the delirium commencing about 9 p.m. and keeping up all night like the fever. The acute mental symptoms appear on rising in the morning, but as the febrile state advances and takes possession the symptoms take on a 9 p.m. aggravation; those that have chill will have it at 9 p.m.; in those who have a fever the fever will come at 9 p.m. If mental symptoms are uppermost they increase and spread over the night... Bryonia will begin at 9 p.m. and run through the night.'

When delirious, Bryonia patients will, in addition to talking of business, often express the wish to go home, even if they are already in their home. The origin of this delirious request is the feeling of security they enjoy when they are in their own place. This trait is very strong.

Bryonia is one of our major polychrests and a remedy that covers a vast amount of pathology. The above description has not exhausted the symptomatology and the conditions in which this remedy could be prescribed, and therefore we give below some characteristic mental conditions for the conscientious student wanting to know more about the mind of Bryonia.

Mental Conditions

Anger and Irritability: ailments after anger, vexation, fright, scorn or acute disappointment and mortification with anxi¬ety. Complaints from hurry; from perceived violence. Anger, irascibility, and irritability; in the evening. Irritability in the morning on waking, during chill, after eating, during headache, during heat, during menses, and during perspiration. Irritability in liver troubles and from cough during whooping cough. Quarrelsome and inclined to scold those around him. Envious of others and feels himself unfortunate. Becomes violently angry from contradiction. After having been angry he is chilly, but has a red face with heat in the head.

Ill Humour: morose during whooping cough. Ill humour with needless anxiety and everything seems to put him in a bad mood. Mocking and sarcastic. Bad tempered and weeping mood. Wearisome, weeping, tearful mood, in day time and at night, before coughing, during the heat, during the perspiration; he feels nervous all day. Taciturn and disinclined to conversation. Answers hastily, does not ask for anything and wishes to be alone. He is averse to any company, particularly the presence of strangers and does not wish to be disturbed. Aversion to being touched.

Dissatisfaction: generally discontented and dissatisfied with himself. Complaining and despondent.

Anxieties and Apprehensions: extreme anxiety for the future, especially in the evening, in bed at night, before midnight; ameliorated in the open air. Anxiety about his health and thinking about his complaints aggravates his symptoms. Baseless anxiety; feels anxious in the house. The state of apprehension is felt in the whole body forcing him to do something constantly. He is always busy and thinks about his work or his business all the time. Hurried, impatient and industrious. Conscientious about trifles. Avarice with a desire to have material objects and make plenty of money. Fear of poverty.

Restlessness: restlessness, nervousness, at night, with anxiety, during headache, during perspiration. Restlessness, causing him to toss and turn in bed and eventually drives him out of bed. Caprice: Capricious mood; has a desire for many things which when offered are refused; desire for change; obstinate. Lacks confidence and becomes hesitant. Timidity.

Stupefaction and Dullness: disinclined to think, with exhausted mental power. Indolence and aversion to work; irresolution. Stupefaction and confused hasty speech. Feels confused in the morning, on rising and in the afternoon, ameliorated in the open air. Persistent thoughts when walking. Confusion during the heat, as after being intoxicated; when lying, while riding, from motion, after sleeping, while walking, ameliorated by yawning. Confusion after drinking; ameliorated with eructations. The mind becomes so weak that his ideas seem to disappear, as if he would faint; he becomes hot in the face and feels worse standing. Inclination to sit. Momentary absence of mind with giddiness and forgetfulness. Dullness and sluggishness, while lying down and during chill. The imagination is sluggish with an inability to make any plans for the future. Ameliorated in the evening with clearness of mind and abundant ideas.

Depression: sadness and depression during heat and perspiration with much sighing. Wants to be quiet during chill and during heat. Becomes oversensitive during the chill. Sensitive to noise. Despair of being cured and fear of death. He has many fears and is easily frightened, the fear rising up from the stomach; fear of being alone, of poverty, of death, of impending disease, of evil, of insanity, of narrow places, of being poisoned, when riding in a vehicle, of suffering, of starving, of thunderstorms. Mental symptoms before and during thunderstorms. Bryonia has ailments from mortification and from chagrin and these are usually headaches.

Psychosis and Delusions: Irrationality and psychosis with a desire to travel. Mental insecurity. Raging and raving during delirium, which occurs at daybreak, in the morning or in the evening, at night. On closing the eyes, he beco¬mes loquacious and busy. He has a presentiment of death and many delusions: as if the bed were sinking, the bed is too hard, imagines he is doing business, sees dead persons, sees faces on closing eyes, illusions of fantasy; thinks is away from home, is in a strange land, is being injured, being beaten; sees people on closing eyes, thought he was pursued by soldiers, sees spectres, ghosts, spirits, friends appear as strangers. Desires to leave home and talks about home. During the delirium he attempts to escape through the window. Impetuous during perspiration with moaning, groaning, during sleep. Symptoms are aggravated by heat. Starting on falling asleep in the evening, also in bed while lying awake; startled from sleep. Muttering and shrieking during sleep and becomes excitable with exaltation of fancies; very anxious and fearful during a fever. Talks about business matters when he is delirious and thinks he is somewhere else and wants to go home. Waves his hands around and gesticulates with the delirium. Unconsciousness in the morning, after delirium, during fever, on rising in the morning and on rising up. Suspicion.

With the information provided above, one can cure any condition that manifests the typical Bryonia picture, be it bronchitis, pneu¬monia, intercostal neuralgia, constipation, diarrhoea, etc. But the symptomatology must be present; dryness, aggravation from motion, irritability, the desire to be left alone, thirst etc.

Generalities

Kent writes:

'This medicine is suitable in a great many diseases, diseases of a typhoid nature, diseases that take on a symptomatic typhoid, diseases that start out as remittents and run into a continued fever, as in pneumonia, pleurisy, inflammation of the liver, of glands, of the bowels, etc. It may be a gastro-enteritis or peri¬tonitis, or inflammation of the bowels, with the sensitiveness, the aggravation from motion and the desire to keep perfectly still. Inflammation of joints, whether of rheumatic character or not, whether from cold, exposure or injury, Bryonia is often indicated in injuries of joints where Arnica would be a failure.

There is an extreme state of irritability in Bryonia; every word which compels him to answer a question or to think will aggravate him. The effort to talk will be attended with horror. At the beginning of complaints you go to the bedside of a patient who has been grumbling a few days; something is evidently coming on; the family meet you at the door and say, "The patient is almost unconscious;" you look at him, the face is puffed and purplish, he seems to be dazed, there appears to be a sort of venous stasis all over the body, but especially about the face; his countenance is almost that of an imbecile, yet he is perfectly capable of talking, although he has an aversion to it and appears to outsiders to ignore everything that is said.

This sometimes comes on apparently in a short time; the patient awakens in the morning with a dull, congestive headache and a stupid feeling in the head; dullness of mind so that he cannot work, and this feeling gradually increases; such a state is sometimes the forerunner of a serious illness. We find, when a pneumonia or inflammation of the liver, or some slow insidious inflammation is coming on somewhere in the body, but not yet located, that this state will begin in the morning. This is peculiar about the aggravation of Bryonia - its troubles commence many times early in the morning. On waking, with the first move, he realises that things are not all right, there is a state of stupidity bordering on unconsciousness. Those who have been grumbling for a week or ten days wake up in the morning feeling miser¬able, some time that night or the next day they have to send for the doctor. If this is watched for a few days, a continued fever is observed. Or at night a chill will come on, with much pain in the chest, rusty expectoration, short dry cough and other symptoms that will be spoken of under Bryonia later, showing that the trouble is going towards the chest; or the condition may gradually increase as a congestive, dull headache. This will be seen when congestion of the brain is coming on...

'...There is a feature worthy of consideration because it sometimes makes a case appear inconsistent. It is due to his anxiety that pervades the whole body. In Bryonia as in Arsenic there comes an anxious and uneasy feeling which compels him to move, but he is worse from motion, yet so uneasy and anxious that he must move. There are pains so violent that he cannot keep still, and yet when he moves he screeches from the pain. So it is really not an inconsistency but simply due to the great violence of the pain. Even though he knows that the motion is going to make him worse, he cannot keep still, for the pain is so violent. Early in the case he was able to keep still, and found that he was better from keeping still, and that the mental state was better from keeping still, and that the anxious restlessness increased the more he moved, until finally a reaction comes and he is obliged to move.

You would think, looking at the case superficially, that patient is better from motion as in Rhus-t., but in Rhus you find that the patient moves and in moving he gets feeble, and when he sits down the pains begin to come on again. There is the distinction between the two, and yet they look alike if not examined into carefully. It is common for Bryonia to be ameliorated from cool air, and from cool applications. Now, if he moves, he gets warmed up, the pains are worse, but there are rheumatic complaints of Bryonia which are better from heat, and under these circumstances he is better from continued motion. It is another form of relief, and another of the modalities. I sometimes wonder whether Bryonia has a greater element of relief from heat, or greater element of relief from cold. Most of the head complaints that are of a congestive character are better from cool applications, from cold air, etc. Yet there are some of the Bryonia head complaints that are relieved by hot applications, and these seem to have no accompanying cerebral congestion. So that Bryonia has opposite modalities, but in all its opposite states there is still a grand nature running all through, sufficient to detect it.

In a damp climate Bryonia is one of the most frequently indicated remedies, but in the clear climates, where the thermometer runs low, Aconite will be indicated more than Bryonia. These atmospheric changes should be thoroughly considered in relation to our Materia Medica. The patient is worse from a warm room, worse from too much clothing, worse from the warmth of the bed, wants the windows open, wants to breathe fresh, cool air. He suffers more than ordinary persons from a stuffy room. Persons who are subject to Bryonia conditions suffer in church, at the opera, in close warm rooms, like Lycopodium. Girls who faint every time they go to church are relieved by Ignatia.'

Bryonia has a marked action on all the serous membranes and the viscera they contain, causing inflammation and exudation. It disorders circulation, alters the blood and gives rise to fevers of the typhoid, bilious, rheumatic and remittent types. The acute symptomatology of Bryonia has a tendency to develop gradually over a course of two to three days, similar to Gelsemium.

Characteristic stitching and tearing pain with aversion to the least movement. The patient avoids even moving the eyes, and raising the head from the pillow causes faintness, nausea and vomiting. This stitching pain is found everywhere, but especi¬ally in the chest. Has strong effect on nerves and muscles, where it causes inflammation and soreness. Muscles become hard, after neuralgia.

The typical Bryonia patient is of dark complexion and hair, plethoric or choleric constitution, has a bilious tendency with firm fleshy fibre and a tendency to great irritability and bad temper. Easily angered (with biliousness, headache, and dyspepsia). Ailments after: anger, catalepsy from anger, chagrin, fright, suppressed eruptions and discharges; alcohol, over-indulgence in rich food and red meat, wounds; black or brown abscesses with acrid pus, suppressed abscesses. Ulcers of the skin with fistulae. Aluminium poisoning. Influenza. Measles after repelled exanthema. Lack of reaction in exanthema.

A remedy which closely resembles Bryonia and which is often effective when a case appears to call for Bryonia but fails to respond to it is Stellaria media. It is a remedy for rheumatism, stiffness of the joints, synovitis, general irritability; the neck muscles are 'stiff and sore'; 'the eyes feel protruded'. There is an aggravation from movement in this remedy as well.

There is typically an aggravation from heat. Complaints from drinking cold drinks in hot weather, from taking cold or getting hot in summer; complaints when the warm weather sets in after cold days. Irritability of mind and tissues runs through this remedy and chilliness predominates. Headache or neuralgia in (left) side of the head and face, aggravated by moving and ameliorated by hard pressure and cold applications.

There is a peculiarity of Bryonia that one may encounter in elderly patients. Arteriosclerotic patients will tend to make a lateral chewing motion with their jaws; it is somewhat like a cow chewing its cud. This chewing motion can also be seen in febrile children when there is brain involvement.

Dryness of the mucous membranes; scanty discharges. Dry, burning heat, as if blood were burning in the veins or one part cold with heat of another. Flushes as if warm water were poured over one and a sensation of heat in the evening in bed. Profuse sour or oily sweat night and morning. Dryness of the mouth and stomach; extreme thirst, worse from drinking beer. Desire for food which cannot be had or refuses things when offered. There are no particularly strong desires and aversions in Bryonia's food preferences with the exception of a strong desire for oysters and for meat. There is also a desire for warm drinks which ameliorate the stomach symptomatology. Bryonia is gluttonous in its eating and suffers many digestive complaints. Food lies like a stone; ameliorated by bringing up wind. Eructat-ions of tasteless gas is characteristic. Symptoms worse after a meal. The tongue is foul and everything tastes bitter. Sour stomach. Digestion usually worse in the summer. Teste regards the digestive canal, and more particularly the stomach, as the principal seat of the action of Bryonia. Diarrhoea in the morning as soon as he moves, but more commonly constipation with large, dry, burnt looking stools. Stools that smell of old cheese. Bryonia is one of the main remedies for constipation when the stool is large, hard, and dry; there seems to be no mucous lining to the intestines to facilitate the passage of the stool. There is also a deficiency of peristaltic activity in the bowels. Inflammation and tenderness of the liver and kidneys. Urine is dark red but without deposit. Haemorrhages are frequent; nosebleed especially in the night around 3-4 am is characteristic. Nosebleed from the suppres¬sion of menses. Bryonia has been found to be curative in chlorosis. Mastitis with hardness and tenderness of the breasts. Pain in the left ovary ameliorated by lying on the painful side. Stupid, drowsy condition during fever, where the patient has the delusion that he is somewhere else and "wants to go home". Headaches which are bursting, splitting and go backwards and are worse for any movement or from coughing. Headaches from over-indulgence in alcohol and food. Convulsions from suppressed eruptions, after perspiration and after haemorrhages where the aura begins with jerking in the nape of the neck. The respiratory organs and heart are profoundly affected. A characteristic of Bryonia is a frequent desire to take a long breath; must expand the lungs. The Bryonia cough can be quite painful; patients will be seen to hold their chests when coughing in order to minimise the painful motion of the chest wall. Dropsical swellings into synovial and serous membranes, painful to touch, which increase as the day goes on and disappear during the night. Hot swelling of the affected parts. Swelling of glands, like nodes. Joints red, swollen and stiff with stitching pain from the slightest motion. Children dislike to be carried or raised. Pains are bursting, stitching or heavy and go backwards and appear gradually. Pain tends to move to the part lain on and after the pain has subsided the patient trembles. On coughing he holds his sides, the chest and the head. Burning pain of parts grasped with the hand and burning and tearing pains externally and internally. Pressing pain as from load or pressing pain outward, from within. Painful joints, worse motion and touch. Often indicated in an injury of the joint when Arnica fails. Stitching in affected parts upon pressure. Jerking, especially in places of the forehead, with sensitivity of the teeth. Bruised or suppurating pain in whole body when taken hold of, especially in the pit of the stomach, worse in the morning. Pain worse on the right side; pain from motion and worse during rest. Drawing pain and tension in almost all the limbs, especially in sinewy expansions. Physical weakness from the slightest exertion, with general sweat. Worse in the morning, on rising; in the morning while walking so that he drags himself about. Weakness felt in the knees and legs on ascending stairs. Unsteadiness of all parts of the body when walking. Faintness on rising from the bed, with cold sweat and rumbling in the abdomen. Disappearance of symptoms after a short rest in bed, except the weakness and depressed mood. Rapid cooling after heated walk causes weakness and sore bruised pain. Symptoms are usually right sided, worse in the morning around 9 a.m. and in the evening at 9 p.m. Aggravation from annoyance, from warmth, in cool days after the summer; from cold wind; change of weather, cold to warm aggravates, becoming hot in a room or in the open air, drinking while hot; warm, wet applications. Aggravation after sitting up, rising from a seat and on beginning to walk, better for continued walking; worse ascending, physical exertion, running, stepping or jar; lying on the side, the painless side, worse from touch. Worse before, at the beginning of and during sleep. Worse from vegetables, acids, early morning. Aggravation from suppressed coryza or suppressed eruptions or discharges.

Amelioration from pressure; made better by lying on the affected part, lying on the back, in a warm bed with heat to the inflamed part, bandaging the affected part, for cool; for open air, for quiet; cloudy, damp days; drawing knees up; descending, sitting up, cold food and drink after eating, from perspiration, from diarrhoea, in the evening from 6-9 p.m.